living in fear of contracting aids

Nov 2, 1998

Dear Dr. Shernoff:

I am currently working with a young man who is a hemophiliac. He came to the US as a young boy from a country where the chances of contracting AIDS from a blood transfusion are much higher than they are in this country. Due to circumstances beyond his control, he may have to return to his native country. He is very concerned about his chances of contracting AIDS from tainted blood if he were to return. I would greatly appreciate if you would offer your expert opinion as to what psychological effect this may have on him, so that I may better understand what he is going through. Thank you.

Response from Mr. Shernoff

He is obviously experiencing a completely normal and healthy terror about contracting HIV. After he returns to his native country, I would expect that he might very likely begn to manifest symptoms of an acute anxiety disorder that can also be accompanied by a reactive depression as his fears grow in repsonse to his needs for blood products.

My clincial suggestions are to begin to try and help him identfiy, by using his premorbid coping styles, defenses and characterological makeup, how he might think his anxiety and depression (which needs to be normalized and not at all pathologized) might present so he will not be surprised by the emergence of a variety of symptoms.

Beginning here, I'd also suggest working with him to try to develop strategies in advance for his coping with these critical uncertainties that can lead to his becoming infected and his potential emotional responses to these expected stressors.

Will it be at all feasable after he leaves the US, for you and he to remain in contact either via phone or e mail, or even through a mail correspondance so that he has the supportive and therapeutic continuity of his relationship with you to help sustain him?

I hope this is helpful. I really feel for him, and for you as his clinician.

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